Difference between revisions of "Neutropenia & leukopenia"
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=Guidelines= | =Guidelines= | ||
| + | '''Given the rapid change in evidence in many areas of hematology/oncology, readers are encouraged to consider any guideline published 5+ years ago to be for historical purposes, only.''' | ||
==ASCO== | ==ASCO== | ||
| − | *'''2023:''' Lehrnbecher et al. [ | + | *'''2023:''' Lehrnbecher et al. [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc10022858/ Guideline for the Management of Fever and Neutropenia in Pediatric Patients With Cancer and Hematopoietic Cell Transplantation Recipients: 2023 Update] [https://pubmed.ncbi.nlm.nih.gov/36689694/ PubMed] |
**'''2017:''' Lehrnbecher et al. [https://doi.org/10.1200/jco.2016.71.7017 Guideline for the Management of Fever and Neutropenia in Children With Cancer and Hematopoietic Stem-Cell Transplantation Recipients: 2017 Update] [https://pubmed.ncbi.nlm.nih.gov/28459614/ PubMed] | **'''2017:''' Lehrnbecher et al. [https://doi.org/10.1200/jco.2016.71.7017 Guideline for the Management of Fever and Neutropenia in Children With Cancer and Hematopoietic Stem-Cell Transplantation Recipients: 2017 Update] [https://pubmed.ncbi.nlm.nih.gov/28459614/ PubMed] | ||
**'''2012:''' Lehrnbecher et al. [https://doi.org/10.1200/jco.2012.42.7161 Guideline for the management of fever and neutropenia in children with cancer and/or undergoing hematopoietic stem-cell transplantation] [https://pubmed.ncbi.nlm.nih.gov/22987086/ PubMed] | **'''2012:''' Lehrnbecher et al. [https://doi.org/10.1200/jco.2012.42.7161 Guideline for the management of fever and neutropenia in children with cancer and/or undergoing hematopoietic stem-cell transplantation] [https://pubmed.ncbi.nlm.nih.gov/22987086/ PubMed] | ||
| + | |||
| + | ==NCCN== | ||
| + | *'''2004:''' Freifeld et al. [https://doi.org/10.6004/Jnccn.2004.0033 Fever and neutropenia clinical practice guidelines.] [https://pubmed.ncbi.nlm.nih.gov/19780251/ PubMed] | ||
| + | |||
=Definition= | =Definition= | ||
*Mild neutropenia: ANC (absolute neutrophil count) 1000 to 1500 cells/uL | *Mild neutropenia: ANC (absolute neutrophil count) 1000 to 1500 cells/uL | ||
Latest revision as of 12:21, 23 June 2024
Guidelines
Given the rapid change in evidence in many areas of hematology/oncology, readers are encouraged to consider any guideline published 5+ years ago to be for historical purposes, only.
ASCO
- 2023: Lehrnbecher et al. Guideline for the Management of Fever and Neutropenia in Pediatric Patients With Cancer and Hematopoietic Cell Transplantation Recipients: 2023 Update PubMed
- 2017: Lehrnbecher et al. Guideline for the Management of Fever and Neutropenia in Children With Cancer and Hematopoietic Stem-Cell Transplantation Recipients: 2017 Update PubMed
- 2012: Lehrnbecher et al. Guideline for the management of fever and neutropenia in children with cancer and/or undergoing hematopoietic stem-cell transplantation PubMed
NCCN
- 2004: Freifeld et al. Fever and neutropenia clinical practice guidelines. PubMed
Definition
- Mild neutropenia: ANC (absolute neutrophil count) 1000 to 1500 cells/uL
- Moderate neutropenia: ANC 500 to <1000 cells/uL
- Severe neutropenia: ANC <500 cells/uL
Evaluation
May consist of:
- CBC with differential
- Basic metabolic panel (BMP)
- Reticulocyte count
- Vitamin B12
- Folic acid
- Copper
- Urinalysis
- LDH
- Uric acid
- C3, C4
- ANA, anti-DNA antibody
- Peripheral blood flow cytometry
- Peripheral smear
- Clinical/infection history, autoimmune/rheumatologic disease, lifestyle factors (e.g. alcohol)
- Medications
- Check for splenomegaly and lymphadenopathy
- Bone marrow biopsy